COVID-19 Pathogenesis and Clinical Manifestations

Acosta, R. Alfonso Hernandez; Garrigos, Zerelda Esquer; Marcelin, Jasmine R.; Vijayvargiya, Priya

doi:10.1016/j.idc.2022.01.003

Cited by 38 publications

(28 citation statements)

References 81 publications

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“…Cytoplasmic pattern recognition proteins detect RNA fragments of SARS-CoV-2, triggering the release of interferons, pro-inflammatory cytokines and leukocyte recruitment [ 32 ]; additional cytokine release occurs when damage-associated molecular patterns in host cells are released in response to injury [ 33 ]. If the innate immune response is dysfunctional, infection will spread, increasing the risk for severe COVID-19; alternatively, if the adaptive B and T cell responses to innate cytokine and chemokine release are absent, uncontrolled inflammation may ensue [ 34 ].…”

Section: Viral Pathogenesis Of Sars-cov-2mentioning

confidence: 99%

COVID-19-Related ARDS: Key Mechanistic Features and Treatments

Selickman

Vrettou

Mentzelopoulos

et al. 2022

JCM

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Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome historically characterized by the presence of severe hypoxemia, high-permeability pulmonary edema manifesting as diffuse alveolar infiltrate on chest radiograph, and reduced compliance of the integrated respiratory system as a result of widespread compressive atelectasis and fluid-filled alveoli. Coronavirus disease 19 (COVID-19)-associated ARDS (C-ARDS) is a novel etiology caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that may present with distinct clinical features as a result of the viral pathobiology unique to SARS-CoV-2. In particular, severe injury to the pulmonary vascular endothelium, accompanied by the presence of diffuse microthrombi in the pulmonary microcirculation, can lead to a clinical presentation in which the severity of impaired gas exchange becomes uncoupled from lung capacity and respiratory mechanics. The purpose of this review is to highlight the key mechanistic features of C-ARDS and to discuss the implications these features have on its treatment. In some patients with C-ARDS, rigid adherence to guidelines derived from clinical trials in the pre-COVID era may not be appropriate.

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Section: Viral Pathogenesis Of Sars-cov-2mentioning

confidence: 99%

COVID-19-Related ARDS: Key Mechanistic Features and Treatments

Selickman

Vrettou

Mentzelopoulos

et al. 2022

JCM

View full text Add to dashboard Cite

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“…Since the first clinical reports of a new form of interstitial pneumonia, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been rapidly identified as the etiological agent responsible for the resulting new coronavirus disease (COVID-19). From a biological point of view, SARS-CoV-2 is a positive-sense, single-stranded RNA virus belonging to the beta coronavirus genus, which shows a very high genetic similarity to other pandemic coronaviruses, namely, SARS-CoV-1 and MERS-CoV (Middle East respiratory syndrome coronavirus), responsible for the SARS and MERS outbreaks in 2002 and 2012, respectively [ 1 , 2 , 3 ]. The viral genome encodes for 4 structural proteins responsible for virus infectivity and replication, and 16 non-structural proteins accounting for virus-specific functions.…”

Section: Introductionmentioning

confidence: 99%

“…The main route of infection is represented by respiratory droplets, and SARS-CoV-2 shows a high tropism to the airway epithelium based on ACE2 expression, thus accounting for the widely observed respiratory manifestations of the disease. Moreover, ACE2 expression is not limited to the respiratory system: this host receptor has also been identified in different human tissues, such as the gut, kidneys, heart, blood vessels, and nervous system, where it is believed to contribute to the known extrapulmonary manifestations of COVID-19 [ 1 , 4 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Biomarkers at the Crossroad between Patient Stratification and Targeted Therapy: The Role of Validated and Proposed Parameters

Rizzi

D’Onghia

Tonello

et al. 2023

IJMS

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Clinical knowledge about SARS-CoV-2 infection mechanisms and COVID-19 pathophysiology have enormously increased during the pandemic. Nevertheless, because of the great heterogeneity of disease manifestations, a precise patient stratification at admission is still difficult, thus rendering a rational allocation of limited medical resources as well as a tailored therapeutic approach challenging. To date, many hematologic biomarkers have been validated to support the early triage of SARS-CoV-2-positive patients and to monitor their disease progression. Among them, some indices have proven to be not only predictive parameters, but also direct or indirect pharmacological targets, thus allowing for a more tailored approach to single-patient symptoms, especially in those with severe progressive disease. While many blood test-derived parameters quickly entered routine clinical practice, other circulating biomarkers have been proposed by several researchers who have investigated their reliability in specific patient cohorts. Despite their usefulness in specific contexts as well as their potential interest as therapeutic targets, such experimental markers have not been implemented in routine clinical practice, mainly due to their higher costs and low availability in general hospital settings. This narrative review will present an overview of the most commonly adopted biomarkers in clinical practice and of the most promising ones emerging from specific population studies. Considering that each of the validated markers reflects a specific aspect of COVID-19 evolution, embedding new highly informative markers into routine clinical testing could help not only in early patient stratification, but also in guiding a timely and tailored method of therapeutic intervention.

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“…4 Most COVID-19 cases are asymptomatic 5 or present mild manifestations, commonly including mild upper respiratory symptoms and/or a systemic influenza-like illness. 6 However, around 5% of infected patients progress to critical disease (respiratory failure, shock, or multiorgan dysfunction 1 ), requiring intensive care unit (ICU) admission. Nutrition care is an essential element in the treatment of critically ill patients, considering the contribution of nutrition therapy (NT) in the mitigation of the metabolic response to stress, as well as in the favorable modulation of the immune response.…”

Section: Introductionmentioning

confidence: 99%

“…Most COVID‐19 cases are asymptomatic 5 or present mild manifestations, commonly including mild upper respiratory symptoms and/or a systemic influenza‐like illness 6 . However, around 5% of infected patients progress to critical disease (respiratory failure, shock, or multiorgan dysfunction 1 ), requiring intensive care unit (ICU) admission.…”

Section: Introductionmentioning

confidence: 99%

Remote nutrition care during the first wave of COVID‐19 pandemic: Did it impact nutrition therapy goals?

et al. 2023

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Background and AimsNutrition societies recommended remote hospital nutrition care during the coronavirus disease 2019 (COVID‐19) pandemic. However, the pandemic's impact on nutrition care quality is unknown. We aimed to evaluate the association between remote nutrition care during the first COVID‐19 wave and the time to start and achieve the nutrition therapy (NT) goals of critically ill patients.MethodsA cohort study was conducted in an intensive care unit (ICU) that assisted patients with COVID‐19 between May 2020 and April 2021. The remote nutrition care lasted approximately 6 months, and dietitians prescribed the nutrition care based on medical records and daily telephone contact with nurses who were in direct contact with patients. Data were retrospectively collected, patients were grouped according to the nutrition care delivered (remote or in person), and we compared the time to start NT and achieve the nutrition goals.ResultsOne hundred fifty‐eight patients (61.5 ± 14.8 years, 57% male) were evaluated, and 54.4% received remote nutrition care. The median time to start NT was 1 (1–3) day and to achieve the nutrition goals was 4 (3–6) days for both groups. The percentage of energy and protein prescribed on day 7 of the ICU stay concerning the requirements did not differ between patients with remote and patients with in‐person nutrition care [95.5% ± 20.4% × 92.1% ± 26.4% (energy) and 92.9% ± 21.9% × 86.9% ± 29.2% (protein); P > 0.05 for both analyses].ConclusionRemote nutrition care in patients critically ill with COVID‐19 did not impact the time to start and achieve the NT goals.

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COVID-19 Pathogenesis and Clinical Manifestations

Cited by 38 publications

References 81 publications

COVID-19-Related ARDS: Key Mechanistic Features and Treatments

COVID-19-Related ARDS: Key Mechanistic Features and Treatments

COVID-19 Biomarkers at the Crossroad between Patient Stratification and Targeted Therapy: The Role of Validated and Proposed Parameters

Remote nutrition care during the first wave of COVID‐19 pandemic: Did it impact nutrition therapy goals?

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